Painful toes can make simple things like wearing shoes difficult. Toes which curl and cause crowding in the shoe can often result not only in discomfort but in the development of a ‘corn’ on the toe. A ‘corn’ is an area of hard skin, like a callus, concentrated in a small area. It often is surrounded by some redness and even swelling.
Some people develop hammertoes as a teenager but most develop them later in life. Shoes are usually not the cause – genetics is. But a tight shoe can definitely make hammertoes more painful.
The first step in alleviating pain and discomfort would be to wear shoes which do not place any pressure on the tops of the toes – either an open toe shoe or one with a roomy ‘toe box’, like a sneaker or lace up casual shoe. Second, reducing the thickness of the ‘corn’ will also relieve some of the pain.
If the condition continues to recur than you may decide to consider having the toe straightened by surgery. Several techniques exist for hammertoe surgery. Dr. Friedman uses what he considers the most natural technique: he does not place any permanent metal or plastic implants in the toe and he does not like to fuse the joint leaving it stiff. Rather he attempts to reduce the hammertoe, making it as straight as possible but still maintaining motion in the toe. The procedure he uses is called a “post arthroplasty” and is a technique that has stood the test of time. A small portion of bone is removed allowing the area to be replaced with the body’s own soft tissue to help contour a straighter toe. When needed Dr. Friedman will release associated ligaments to further relax the toe. In some case he will make use of a temporary metal pin to splint the toe for 3-4 weeks.
Patients can walk after the surgery but are best off allowing 2-3 days to take it easy at home, elevate their foot and help reduce the swelling. Stitches are removed after two weeks. Many patients return to a loose closed shoe like a sneaker after 3-4 weeks, but that is dependent on the swelling. People who have desk or office jobs can usually return to work within a day or so of the surgery.
Dr. Friedman will discuss non-surgical and surgical options for the treatment of your hammertoes. If surgery is right for you he will review the procedure and follow-up care in detail along with when you can expect to resume your normal activities.